2019 health care it industry trends...sources: wachter r, “the digital doctor - hope, hype, and...
Post on 23-May-2020
2 Views
Preview:
TRANSCRIPT
Health Care IT Advisor
2019 Health Care IT
Industry Trends
© 2019 Advisory Board • All rights reserved • advisory.com
2
Industry transformation took many forms in 2018
The threat of disruption is catalyzing and accelerating broader trends
Source: Health Care Advisory Board interviews and analysis.
Primary care
operator
Consumer-focused
technology platform
Global health care
logistics specialist
Employer
aggregator
Next-generation
retail pharmacy
Emerging themes in the efforts to disrupt the health care value chain
Commercial
payers at the
forefront
Heightened
focus on
input costs
Data-driven
utilization
management
Active steerage
over hands-off
delegation
The primacy
of the
independent
physician
© 2019 Advisory Board • All rights reserved • advisory.com
3
84 health care CIOs told us their 2019 top priorities1
Source: Health Care IT Advisor research and analysis.
1) Priorities are grouped according to similar areas of focus.
Foster a data-driven culture at my organization (e.g., data governance, self-service BI, physician trust in data)
Understand applications and use cases for emerging technologies and communicate challenges
Develop and prepare leadership for IT’s evolving role (e.g., roles, organizational structure)
Lay the foundation for innovation (e.g., funding, leadership, partnerships, innovation platform)
Build a mature analytics program that delivers better value in clinical and administrative settings
Develop an integrated platform to support the digitally-enabled patient (e.g., digital front door, mobile apps)
Use AI and machine learning to generate high quality predictions and automate processes
Prioritize and deploy emerging technologies (e.g., the “when, why, and how”)
Improve clinician experience and usability (e.g., workflow, burnout, training/education)
Accelerate value realization from major IT investments (e.g., application optimization, IT governance)
© 2019 Advisory Board • All rights reserved • advisory.com
4
Three themes emerged from the top priorities
1Promote IT
organizational excellence
• Help the organization extract value from existing IT• Plan for next-stage optimization• Develop the IT workforce of the future
2Optimize care
delivery
• Leverage new data sources• Improve IT usability and the clinician experience• Build a digital platform for the “era of the connected patient”
3Embrace digital
disruption and innovation
• Embed digital transformation within strategy and culture• Understand the innovation landscape• Evaluate and deploy emerging technologies
© 2019 Advisory Board • All rights reserved • advisory.com
5
Promote IT organizational excellence2019 health care IT industry trends
• Help the organization extract value from existing IT
• Plan for next-stage optimization
• Develop the IT workforce of the future
THEME
1
© 2019 Advisory Board • All rights reserved • advisory.com
6
The “IT value equation”– to invest or not?
Ongoing efforts by non-IT and IT leaders are required to get “IT value”
Promote IT organizational excellence
Sources: Wachter R, “The Digital Doctor - Hope, Hype, and Harm at
the Dawn of Medicine's Computer Age,” New York: McGraw-Hill Education, 2015; Health Care IT Advisor research and analysis.
1) Return on investment.
Benefits
Costs (and time)
Automation,
point solutions
justif ied by ROI1
Enterprise apps and analytics,
focus on operational excellence
Centralization, standardization to
reduce IT spending grow th rate
Digitization, optimization,
interoperability, focus on digital
strategy enablement and
innovation at scale
Complexity created by multiple
point solutions
“Like a safe deposit box, unlocking IT’s potential requires the turning of two keys—the technology itself and the redesign of the surrounding environment.”
Dr. Robert M. Wachter, Professor and
Chair, Department of Medicine, UCSF
© 2019 Advisory Board • All rights reserved • advisory.com
7
Most IT resources go to “keeping the lights on”
Promote IT organizational excellence
Sources: Hayward D, “Navigating Healthcare IT Transformation and
Economics,” Dell, Feb 29, 2016; Health Care IT Advisor research and analysis.
1) Keeping the lights on.
KTLO1 costs stifle digital innovation
KTLO cost contributors
Infrastructure operations and maintenance
Application operations and maintenance
Updates and capacity expansion
Leaving fewer resources for new initiatives and innovation
Up to 78%Of IT operations budget is often devoted to KTLO functions, with the remainder left for new projects
Architecture / infrastructure modernization
Includes cloud / virtualization, software-
defined everything, and networks
Application standardization
Simplify the application portfolio
Technology portfolio rationalization
Includes infrastructure, processes,
and technology
Sourcing
Leverage shadow IT and selective
outsourcing
Four ways to approach KTLO
© 2019 Advisory Board • All rights reserved • advisory.com
8
Technology is a vital tool for long-term cost control
But value requires effective governance
Promote IT organizational excellence
Source: Health Care IT Advisor interviews and analysis.
IT-enabled long-term cost control and connected benefits
• Identify variation in
inputs, w orkflow s,
processes
• Understand costs
and impact of
decisions
• Measure and track
outcomes, results,
progress
• Reduce care
variation
• Improve clinical
outcomes
• Reduce
administrative
burden on
clinicians
• Shift w ork to low er-
cost staff, to
consumers
• Automate processes
and decisions
• Reduce cognitive
burden
• Optimize space and
resource utilization
• Virtualize care,
collaboration, and
coordination
Identify,
quantify, and
measure
Improve and
transform care
delivery
Operate more
efficiently
• Function as
a virtually
integrated
enterprise
• Standardize,
centralize,
rationalize
Facilitate true
systemness
Strengthen IT
performance
• Extract and
demonstrate
greater value from
technology
investments
• Improve KTLO
costs and IT
performance
• Lay the foundation
for innovation
© 2019 Advisory Board • All rights reserved • advisory.com
9
“Systemness” will continue to be crucial for success
Systemness is the willingness and ability to do hard things
Promote IT organizational excellence
Source: Health Care IT Advisor research and analysis.
Operational advantage
Degre
e o
f m
ark
et
advanta
ge
Degree of “systemness”
Productadvantage
Structural advantage
Transformational advantage
Cultural threshold:
Recognize and
pursue economies
of scale
Cultural threshold:
Work together
toward difficult but
common objectives
Cultural threshold:
Take actions that
benefit the system
as a whole even
when they may be
unattractive to
some of its parts
Cultural threshold:
Commit to change
that is broadly
disruptive when
that change is
necessary for
long-term success
• Centralized
business functions
• Supply chain
efficiencies
• Scalable process
eff iciencies
• Clinical
standardization
• Solution-oriented
product portfolio
• Footprint
rationalization
• Optimal capital
allocation
• Scalable population
health identity
© 2019 Advisory Board • All rights reserved • advisory.com
10
The hospital of the future needs new rules
Business leaders must learn basic IT and analytics competencies
Promote IT organizational excellence
Source: Health Care IT Advisor research and analysis.
Manage IT as an expense (support function) Manage IT as an asset (core competence)
Operational excellence / stability Operational excellence / stability and agility
Use IT to automate manual processes Use IT to digitize (processes and patients)
Risk in leading, fast follow ing Risk in being “late to the party”
Failure is not an option Fail small and fast / learn / apply lessons
Develop detailed plans for your (big) bets Experiment, try lots of things w ithin big bets
Inside-out view of the organization Outside in (start w ith customer journeys)
Decisions by gut feel Decisions informed by data, big data
IT-f
ocused
Org
aniz
ational
Old rules New rules
© 2019 Advisory Board • All rights reserved • advisory.com
11
Talent is critical to digital strategy success
Leverage your organization’s mission / vision to attract talent
Promote IT organizational excellence
Sources: “2018 Digital Transformation Readiness Survey,” Appian and
DevOps.com, https://www.appian.com/resources/2018-d igit al-transform ation-readiness-survey/; Health Care IT Advisor research and analysis.
Obtain and retain the needed skillsets
Are you seen as a potential employer for the skills you need? Do you have relationships with local universities?
Cultivate a digital innovation mindset
Is your staff appropriate for the digital maturity stage?
Encourage life-long learning
Are team members willing to continuously evolve their skills?
Appian Digital Transformation Readiness Survey
Of organizations can’t attract the quality and
quantity of softw are engineers they need to
feed the business w ith innovative technology
82%
Assess what you have today1
Forecast what you will need for the future2
Develop a plan for the future3
© 2019 Advisory Board • All rights reserved • advisory.com
12
The CIO role is making headlines
Promote IT organizational excellence
Source: Health Care IT Advisor research and analysis.
- Healthcare IT News (November 2018)
“Role of CIO Is Changing and Growing in Importance, Say New Forbes Insights Studies”
“The Evolving Healthcare CIO: Innovation over Information”
“How Digital Transformation Is Changing the Jobs of CIOs and IT Pros”
“Healthcare CIOs See Roles Slip in Decentralized Analytics World”
- HealthITAnalyltics.com (November 2018)
- Healthcare Informatics (November 2018)
- Forbes (March 2018)
© 2019 Advisory Board • All rights reserved • advisory.com
13
Analytics leadership shifts away from tech leaders
Surveys show a sharp rise in shared leadership over the past few years
Promote IT organizational excellence
Source: Health Care IT Advisor research and analysis.
43.8%
10.4%
8.3%
6.3%
6.3%
6.3%
4.2%
4.2%
2.1%
2.1%
2.1%
2.1%
2.1%
CIO
VP of Analytics (or similar title)
CMIO
COO
VP of Network Development/Strategy
CFO
CMO/CCO
CQO
CEO
VP of Contracting
Do not have anyone from the C-Suite
Shared leadership
No real leadership
C-suite executives leading analytics efforts in 2015 survey (n=48)
25.3%
21.5%
11.4%
7.6%
6.3%
6.3%
5.1%
5.1%
5.1%
5.1%
1.3%
Shared leadership
CIO, VP of IT
CFO
COO
CTO or similar VP
Other
CDO, CAO, or similar VP
CQO, CPO
CMO, CMIO, CNO, CNIO
No real leadership
CSO
C-suite executives leading analytics efforts in 2018 survey (n=79)
© 2019 Advisory Board • All rights reserved • advisory.com
14
CIOs should adapt to the changing environment
New titles and responsibilities can complicate the picture
Promote IT organizational excellence
Source: Health Care IT Advisor research and analysis.
Chief Digital OfficerChief Information Officer
• Runs IT operations, enables digital
innovation
• Focuses on operational excellence, agility
• Has more of an internal, automation focus
• Addresses stability, risk mitigation
• Builds and supports IT infrastructure
• Manages technology vendors
• Leads digital innovation
• Focuses on big problems w ithout packaged
solutions
• Has more of an external, digitization focus
• Addresses speed, external threats,
organizational agility
• Builds and supports innovation capabilities
• Initiates and manages external partner
relationships
One example: How the roles of the CIO and CDO could tie together
IT leaders who succeed in this age of digital disruption will be those who act proactively and reinvent their own roles within the organization
© 2019 Advisory Board • All rights reserved • advisory.com
15
Optimize care delivery2019 health care IT industry trends
• Leverage new data sources
• Improve IT usability and the clinician experience
• Build a digital platform for the “era of the connected patient”
THEME
2
© 2019 Advisory Board • All rights reserved • advisory.com
16
Technology continues to drive the flood of data
Data erupts from smartphones, genomes, sensors, and other sources
Optimize care delivery
mHealth
Sensors /
Wearables
Internet of
things
Patient
history
Telemedicine/
Virtual v isitsSocioeconomic
factors
Connected health
Screenings /
Lab tests
Imaging
“Omics” data
Lifestyle /
Health
behav iors
Physical
env ironment
Pharmacy
data
Elements of connected health
© 2019 Advisory Board • All rights reserved • advisory.com
17
New data sources surge since 2015 survey
Structured data still foundational to analytic models
Optimize care delivery
Source: Health Care IT Advisor research and analysis.
1) N=43.
Included now
(2015)
Included now
(2018)1 Plan to add in 2019
Structured financial data 87% 88.4% 4.7%
Structured clinical data 89% 79.1% 9.3%
Clinical partner data 31% 70.7% 14.6%
Patient-reported data 26% 55.8% 23.3%
Unstructured clinical data 12% 45.2% 26.2%
Research data 23% 39.0% 19.5%
Unstructured nonclinical data 10% 36.6% 19.5%
Social determinants data N/A 34.1% 48.8%
Social media data 7% 20.0% 25.0%
Mobile or IoT dev ice data 10% 14.6% 31.7%
Genomic data 10% 2.5% 15.0%
Q: Which types of data are already included in your analytic models and which do you anticipate including in the future?
© 2019 Advisory Board • All rights reserved • advisory.com
18
Time to think beyond the hospital’s four walls
Mainstream systems cover only a fraction of predictive power
Optimize care delivery
Sources: Nash DB, “Population Health: Why It Matters,” Essentials in
Population Health, Children’s Hospital Association, Thomas Jefferson University, October 2016; Health Care IT Advisor research and analysis.
1) Remote patient monitoring.
EHR(s)
Lab systems
Pharmacy systems
Imaging
Medical claims
Prescription drug claims
Billing and supply chain
Scheduling systems
Medical care data
10%
Sensors / RPM1
mHealth apps
Patient-reported outcomes
Genetics
Socioeconomic data
Patient questionnaires
Human biology data
20%
Lifestyle and
behavior data50%
Social and environmental
data20%
Data sources by influence on health outcomes
© 2019 Advisory Board • All rights reserved • advisory.com
19
Improving the clinician experience
The EHR continues to be a focal point for physician burnout
Optimize care delivery
Sources: Peckham C, “Medscape Lifestyle Report 2017: Race and Ethnicity, Bias and
Burnout,” Medscape, January 2017; Health Care IT Advisor research and analysis.
Human factors
Human factors is a scientific discipline that aims to help people do their best work, improve resilience and overall system performance, and minimize errors.
Usability
Usability is the effectiveness, efficiency, and satisfaction with which specific users can achieve a specific set of tasks in a particular environment.
Two components influence EHR
user experience:
To learn more about this topic, Health Care IT
Advisor members can read our report How to
Reduce Physician Burnout During EHR
Optimization
Four tactics to reduce clinician burnout
during EHR optimization
Collect, analyze, and act on user
data to improve system usability
and safety
1
Address clinician needs w ith the
appropriate amount of special
configuration w ork via a managed process
2
Reexamine your clinician
education/training approach3
Give your vendor feedback4
A survey of 14,000 physicians found three of the top five causes of physician burnout were associated with spending too much time in the EHR
© 2019 Advisory Board • All rights reserved • advisory.com
20
A vision for connected health
Optimize care delivery
Sources: Aitken M, et al., “The Growing Value of Digital Health: Evidence and Impact on Human Health and the
Healthcare System,” IQVIA Institute for Human Data Science, November 2017, https://www.iqvia.com/institute/reports/the-growing-v alue- of-digita l-healt h; Health Care IT Advisor research and analysis.
Data from patients’ daily lives will support better health
outcomes for the individual and the population
Data generation
and capture
Tertiary use of data:
transform the health
care delivery system
Primary use of data:
support the patient
Secondary use of data:
improve the population
Symptom
onset
Patient experience
tools
• General health info
• Symptom checkers
• Clinician search
• Managing clinical /
financial info
• Social media
Diagnosis
Doctor may
recommend
app-supported
disease
mgmt. programs,
connected sensors
for RPM, or apps for
uses across the
patient journey
Treatment
Prescription filling
and compliance
• Prescription
discounts
• Prescription fi l ling
• Medication
management,
adherence
Wellness and
prevention
Wellness and
prev ention
• Exercise
• Diet and nutrition
• Lifestyle
• Stress mgmt.
• Sleep
Condition
management
Condition
education and
mgmt.
• Self-monitoring
• Rpm
• App-enabled
rehab programs
© 2019 Advisory Board • All rights reserved • advisory.com
21
Let’s not forget about the consumer / patient
Optimize care delivery
Source: Health Care Advisory Board interviews and analysis.
“I need a
Rx refill”
“My child
has a fever”
“Am I healing
after surgery?”
Urgent care
E-visit
Retail clinic
Emergency department
“Do I need
stitches?”
“Is this mole a
problem?”
“I need a
flu shot”Primary
care
Asynchronous consult
Telephone consult
Loyalty platform
“Where do I go?”
Connected platforms reduce the risk of fragmentation
© 2019 Advisory Board • All rights reserved • advisory.com
22
Mergers aim to rebuild the system’s “front door”
As disruption looms, incumbents race to lock up the market
Optimize care delivery
Sources: Google Finance; Health Care Advisory Board interviews and analysis.
1) As of May 15, 2018.
$249.5B
$230.2B
$66.9B
$40B
$42.8B
$11.6B
$57.9B
$41.4B
Com
bin
ed m
ark
et
valu
ation
1
Potential industry disruption
Drivers of deal activity
Tax reform brings for-profit companies
an influx of cash
Margin pressure intensifies capital needs
in certain sectors
Shifting administrative priorities changes sources
of projected growth
Walmart
Express Scripts
Humana
Aetna
Optum
Cigna
CVS Health
DaVita Medical Group
UnitedHealth Group
© 2019 Advisory Board • All rights reserved • advisory.com
23
Investing big in the consumer-driven future
PSJH1: Digital strategy tied to enterprise strategy
Optimize care delivery
Source: Martin A, Vaezy S, “Digitally Transforming Providence St.
Joseph Health across 6 Digital Journeys,” GeekWire, Dec 2017.
1) Providence St. Joseph Health.
2) Emergency department.
Six digital journey domains
Access and personalization
Provide access to various care
modalities and deliver
personalized experiences
Simplifying care
Ease system navigation for
patients through digital pathw ays,
self-management and education
tools, virtual visits, simplif ied
billing, medication management,
and access to non-clinical services
Make caregiving easier
Increase provider quality of life
and focus on patient
encounters through automation
of documentation in the EHR
and inbox management
Better serve Medicaid
Improve navigation to avoid
unnecessary ED2 visits
Power behavioral health
Use digital tools to address stigma,
low supply of caregivers, and lack
of screening
Enable new revenue streams
Explore new clinical revenue
streams, product revenue, and
technology commercialization
© 2019 Advisory Board • All rights reserved • advisory.com
24
The rising bar for patient engagement
Must-have upgrades for the consumer-focused health system
Optimize care delivery
Sources: Health Care Advisory Board research and analysis; Revenue
Cycle Advancement Center (RCAC) research and analysis.
1) RCAC survey of adult patients; Question: ““Which is most
important to you when choosing a hospital or health care provider to undergo a non-emergency surgery?” (n=1,000).
Status quo Must-have upgrade
One-size-fits-all Multimodal access network
Lack of attention to service quality
High-reliability production model
Premium pricing across the board
Competitive price point
Relationships purely transactional
Loyalty reward program
User-unfriendly Frictionless transactions
Patient survey: Most important factor on provider choice1
44% It’s easy to schedule
41% I know exactly w hat I ow e before getting care
15% I can pay using a payment plan
© 2019 Advisory Board • All rights reserved • advisory.com
25
Embrace digital disruption and innovation2019 health care IT industry trends
• Embed digital transformation within strategy and culture
• Understand the innovation landscape
• Evaluate and deploy emerging technologies
THEME
3
© 2019 Advisory Board • All rights reserved • advisory.com
26
Digital health systems: automation to digitization
Organizational strategies and digital strategies must converge
Embrace digital disruption and innovation
Source: Health Care IT Advisor research and analysis.
The focus of digital health
systems
Potential
value, people,
process, and
technology
change
1980s and 1990s
Current and future: Focus on digitization (fundamental rethink)
IT as a cost to be minimized
IT as an efficiency tool
IT-enabled strategies
Digital business and clinical
transformation, disruption, and
innovation
1990s and 2000s:Focus on automation(of manual processes)
Digital health systems take full advantage of digital technologies and IT-related capabilities to redefine business models; rethink processes, quality, and their cost structure; and identify and address customer or patient needs.
© 2019 Advisory Board • All rights reserved • advisory.com
27
Digital health systems have become a necessity
Signs of transformation and disruption are prevalent
Embrace digital disruption and innovation
Source: Health Care IT Advisor research and analysis.
1) Accountable care organizations.
2) Centers of excellence.
Volumes to value and affordability
Passive recipients to active participants
“Find it, fix it” to predictive and preventive
Pricing and reimbursement• Transparent pricing
• Dynamic pricing
• Risk-based and
risk-adjusted payments
New products and services• ACOs1
• Episodes of care
• Referral management
• Navigation
• Wellness
Access
• Expanded hours, locations
• Lower-cost care sites
• Regional, national COEs2
• Virtual care
• Wearables, embedded sensors
• Smart, connected pill bottles, houses
• Predictive, “precision engagement”
• “Pay How You Live”
• Information symmetry
• Shared decision making
• Early detection
• Computer-assisted diagnosis, Tricorder
• Precision medicine
• Learning health care system
• Reduction of duplicationand w aste
Business models Care deliveryPatients / consumers
To explore this topic in more depth, Health Care IT
Advisor members can watch our webconference
recording Digital Health Systems: The Innovation
Journey Continues
© 2019 Advisory Board • All rights reserved • advisory.com
28
Digital health funding continues at a record pace
The industry is seeing more dollars and bigger deals
Embrace digital disruption and innovation
Source: StartUp Health Insights, “StartUp Health’s 2018 Insights Funding Report: A Record Year for Digital Health,” January
2019, https://hq.startuphealth.com/posts/startup-healths-2018-insights-funding-r eport- a-rec ord-y ear-for- digita l-healt h.
Digital health funding snapshot
(annual total in $B): 2010 to 2018
“2018 was the biggest year for digital health since StartUp Health began tracking the market in 2010. Digital health funding was 14 times more than what it was eight years ago, and from 2017 to 2018, average deal size grew by $6M.”
$1.2$2.0 $2.3
$2.9
$7.1$6.2
$8.2
$11.7
$14.6
2010 2011 2012 2013 2014 2015 2016 2017 2018
153
283
476
647608
568
684
851
765
Deal count
© 2019 Advisory Board • All rights reserved • advisory.com
29
Big tech companies set their sights on health care
Embrace digital disruption and innovation
Sources: “Apple and Amazon’s moves in health signal a coming transformation,” The Economist, February 2018; “Top of Mind
for Top Health Systems 2019,” Center for Connected Medicine, November 2018, https://connectedmed.com/blog/content/top-of-mind-2019-interoperabil ity-cybersecurity-t elehealth; Health Care IT Advisor research and analysis.
Two routes into health care
Big five tech vendors in health care
• Health Records
• CareKit
• ResearchKit
• Apple Watch
EKG
• Medical clinics
• Berkshire
Hathaw ay/Chase
partnership
• Alexa virtual
assistant
• PillPack
• Verily – health
insurance, 3M
• Cityblock Health
• DeepMind
Health (AI)
• Behavioral
health detection
• Clinical trials
• AI-pow ered
virtual health
assistants
• HoloLens
• Walgreens
partnership
More powerful tools for a more receptive market?
Apple Amazon Google Facebook Microsoft
Do business w ith health systems and
companies in the existing systemUse tech platforms to create new health
care-delivery channels
Of surveyed health system executives are very or somewhat concerned about big tech companies entering the health care space (n=44)80%
© 2019 Advisory Board • All rights reserved • advisory.com
30
Emerging technologies poised to disrupt health care
Health care providers prepare to prioritize, fund, and deploy new IT
Embrace digital disruption and innovation
Source: Health Care IT Advisor interviews and analysis.
1) Natural language processing.
2) Medical body area network.
Dev ices• Bendable• Modular design
• 3D cameras• Wireless charging
Networks• 5G, HaLow,
MBAN,2 Li-Fi,
Satellite
Apps• More comprehensive• Products, not features
Precision medicine• Genetic screening, DNA
sequencing
• Personalized health• Pharmacogenomics
Medical dev ices• Miniaturization• Ingestibles
• DNA sequencers
Virtual and augmented reality• Surgical training with holograms• Exposure therapy
• Pain management• Patient education
3D printing• Prosthetic limbs• Preoperativ e planning
• Pharmaceuticals• Bioprinting
Advances in mobility
Virtual assistants and bots• Google Assistant• Amazon Alexa
• Microsof t Cortana
Blockchain• Single, shared records without the
need f or trusted intermediary
• Securely record contracts, value transf ers, and other data
Internet of things• Env ironmental sensors• Internet of nanothings
• Microelectromechanical sy stems (MEMS)
Artificial intelligence• Machine and deep learning• Language translation and NLP1
© 2019 Advisory Board • All rights reserved • advisory.com
31
Majority of leaders have a positive view of AI
But a fair amount of uncertainty still exists
Embrace digital disruption and innovation
Source: Health Care IT Advisor research and analysis.
Q: Which of the following best describes your leadership team's views on the potential of artificial intelligence to advance organizational objectives? (n=114)
30.7%
5.3%
27.2%
36.8%
We believe AI will become a
transformative, essential
part of our health system
We don’t know what AI
can do or what role it
might play
We don't believe AI will
deliver significant value
We believe AI will deliver
incremental value
For more survey results,
w atch our w ebconference
recording 2018 Analytics
and AI Survey
© 2019 Advisory Board • All rights reserved • advisory.com
32
Large organizations are the most optimistic about AI
While smaller organizations are less certain about AI’s potential
Embrace digital disruption and innovation
Source: Health Care IT Advisor research and analysis.
Q: Which of the following best describes your leadership team's views on the potential of artificial intelligence to advance organizational objectives?
45.2%
3.2%
22.6%
29.0%26.9%
5.8%
28.8%
38.5%
16.0%
8.0%
32.0%
44.0%
We believe AI will deliver
incremental value
We believe AI will become a
transformative, essential
part of our health system
We don't believe AI will
deliver significant value
We don’t know what
AI can do or what
role it might play
MediumSmall Large
© 2019 Advisory Board • All rights reserved • advisory.com
33
Digital disruption and innovation won’t be easy
Plan for these challenges ahead of time
Embrace digital disruption and innovation
Source: Health Care IT Advisor research and analysis.
Business challenges Legal and ethical challenges
Complexity: Medical issues do not
appear in isolation and coordination
of care is diff icult.
Threat to human jobs : Strong fear
associated w ith technology displacing
human w orkers.
Workflow : How do solutions f it into
existing w orkflow s? How much effort
is required to use it? Does it interfere
or annoy unnecessarily?
Competing priorities: We are still in
the midst of installing basic and
foundational systems (e.g., EHRs)
w hile addressing regulatory and
other pressing PHM initiatives.
Regulation: Health IT regulations
are hotly debated at the national
level. Finding the right balance of
public health protection and fostering
innovation is key.
Legal: Juries still aw ard large sums
w hen health care is not applied
properly or expected outcomes are
not achieved.
Liability: How do w e deal w ith
computer failings? Even if AI
approaches are statistically better,
there may be liability w hen it fails.
Human touch: how w ill w e interact
w ith AI? How strongly w ill w e require
the human touch and human
compassion in health care?
Cost: The high costs for
developing, testing, certifying, and
implementing can be a barrier.
© 2019 Advisory Board • All rights reserved • advisory.com
34
Cultural change is a key barrier to innovation
Culture Change
Embrace digital disruption and innovation
Sources: Friedman S, Thank You For Being Late, New York: Farrar, Straus
and Giroux, 2016; Shah S, et al., “Leading Change—A National Survey of Chief Innovation Officers in Health Systems,” Health Management Policy and
Innovation, 3, no. 1 (2018); Health Care IT Advisor research and analysis.
CIOs must lead IT culture change, contribute to organizational change
Rate of technological change exceeds
human capacity to adapt
Rate
of change
Time
Rate of technological change
Human capacity to change
(We are here)x
Organizational culture is a system of shared
assumptions, values, and beliefs, w hich
governs how people behave in organizations.64%
Of innovation executives said the
biggest barrier to innovation is
culture/organizational structure
© 2019 Advisory Board • All rights reserved • advisory.com
35
Source: Pearl R, Mistreated: Why We Think We're Getting Good Health
Care and Why We're Usually Wrong, New York: PublicAffairs, 2017.
Invariably, people will resist the transformation of
health care…that’s why the true test of successful
leadership is best measured months or even years
later. It is defined by whether those who dragged
their feet at first would ever choose to go back to
how things were done before.”
Dr. Robert Pearl
Physician, professor, and author
Former CEO of The Permanente Medical Group
© 2019 Advisory Board • All rights reserved • advisory.com
36
Next steps and key considerations2019 health care IT industry trends
© 2019 Advisory Board • All rights reserved • advisory.com
37
Optimize care delivery
Embrace digital disruption and
innovation
Promote IT organizational
excellence
A brief recap of topics we covered
Next steps and key considerations
Source: Health Care IT Advisor research and analysis.
• Leverage new data sources
• Improve IT usability and the clinician experience
• Build a digital platform for the “era of the connected patient”
• Help the organization extract value from existing IT
• Plan for next-stage optimization
• Develop the IT workforce of the future
• Embed digital transformation within strategy and culture
• Understand the innovation landscape
• Evaluate and deploy emerging technologies
© 2019 Advisory Board • All rights reserved • advisory.com
38
Foundational competencies of digital health systems
“No regrets” enablers of digital strategy and innovation
Next steps and key considerations
Source: Health Care IT Advisor research and analysis.
Align IT-related activities with business needs through good governance and strategy processes
Manage “keeping the lights on” costs and provide a stable, reliable, scalable, and secure operational backbone
Build the capabilities to exploit technology assets (e.g., developing advanced analytics and interoperability capabilities)
Ensure availability of adequate skills and resources through talent management and partner management
Build upon existing skills to improve IT departmental and organizational agility and help change organizational culture
Digital strategy and innovation
© 2019 Advisory Board • All rights reserved • advisory.com
39
Obtain and retain new skillsets and mindsets
Move to broad IT skills, build analytics and app development skills
Next steps and key considerations
Source: Health Care IT Advisor research and analysis.
Consider who should track emerging technologies and potential impacts on the business
Obtain skills
Retain skills
• Create an innovative, results-oriented, dynamic
environment
• Develop career paths that rew ard “makers,” not
just managers
• Provide flexible roles and organizational structures
• Encourage and expect lifelong learning
• Connect staff to organizational mission, emphasize
corporate social responsibility, and provide
opportunities to help educate the community
• Train w ithin IT and help non-IT people develop
needed IT-related skills
• Partner for skills
• Contract for skills: consider e-lancing / the
gig economy
• Hire: permit telecommuting and consider tools
to enable remote communication and w ork
Action
steps
Action
steps
Build a diversity of skills,
backgrounds, mindsets,
and decision-making
styles among your staff.
© 2019 Advisory Board • All rights reserved • advisory.com
40
Leveraging new data sources for care delivery
ONC’s1 vision for PGHD through 2024
Next steps and key considerations
Source: “Conceptualizing a Data Infrastructure for the Capture, Use, and Sharing of Patient -Generated Health Data in Care Delivery and
Research through 2024,” Accenture Federal Services, January 2018, https://www.healthit.gov/sites/default/files/onc_pghd_f inal_white_paper.pdf .
1) Office of the National Coordinator for Health Information Technology.
Current state Future state
• Continuous electronic capture and
sharing of PGHD betw een patients,
caregivers, clinicians, and researchers
• Holistic perspective of the patient’s health
• Patients at the center of care delivery
• Balanced relationships betw een the
patient and clinicians/researchers
• Decisions typically based on data
collected in the clinical setting
• Isolated snapshots of patient health
• Patients are commonly the most
underutilized resources in health care
Relies heavily on episodic care A focus on value-based care,
enhanced with PGHD
Health care system
2016-2017 (Early adoption)
• Cutting-edge organizations
begin pilot testing and
researching use of PGHD for
specific chronic diseases
• Interest in precision medicine
and telehealth increase focus
on PGHD
2018-2023 (Growth)
• Increasing number of patients
will ing to capture/share PGHD with
clinicians and researchers
• PGHD interoperability standards
are adopted
• Clinicians easily able to store, retain,
and analyze large volumes of PGHD
with minimal concern for l iability
2024 (Maturity)
• PGHD seamlessly and securely
flow from patients to clinicians as
part of routine care
• Patient-provider relationship is
balanced and collaborative
• Patients actively engage in
monitoring health; make fewer
trips to the doctor
© 2019 Advisory Board • All rights reserved • advisory.com
41
Leveraging new data sources for care delivery (cont.)
OCHIN’s1 conceptual model for SDH data in primary care
Next steps and key considerations
Sources: DeVoe JE, et al., “Perspectives in Primary Care: A Conceptual Framework and Path for Integrating
Social Determinants of Health Into Primary Care Practice,” Annals of Family Medicine, 14, No. 2 (March 2016): 104-108, http://www.annfammed.org/content/14/2/104; Health Care IT Advisor interviews and analysis.
1) Formally known as the Oregon Community Health Information Network.
Community vital signs data
Imported from public data sources
about community-level information
(e.g., US Census) matched to
patient address
Patient-reported data
Collected by asking patients direct
questions about their individual
circumstances (e.g., employment,
education, housing)
Panel management
Population of patients
Point-of-care
Individual patient care
Improved
health
outcomes
(+Research
and policy)
Collect and
organize
SDH data
1
Present and
integrate SDH
data into primary
care w orkflow s
2
SDH data triggers
automated support
and action
3
Referrals to social services, medical specialists
Clinical decision support
Patient engagement
Clinical and social services coordination
© 2019 Advisory Board • All rights reserved • advisory.com
42
Do not overlook potential partners
Even large organizations are not “going it alone”
Next steps and key considerations
Source: Health Care IT Advisor research and analysis.
1) Venture capital.
Do w e know w hat and how to measure?
What data w ill be shared?
Have w e identif ied the goals/desired
outcomes and w hat (initial) success looks
like for all partners?
What capabilities w ill have to be developed
or integrated?
Have w e scheduled regular checkpoints
w ith the right people?
Have w e assigned the right people?
Are they trained adequately?
Questions to evaluate partnerships
Have w e clearly identif ied roles,
responsibilities, and accountabilities?
Have w e addressed cybersecurity needs?
Strategic partner ecosystem
Start ups and VC1 firms
Traditional vendors (e.g., EHRs)
Non-traditional vendors (e.g., Google, Amazon, Apple, Microsoft, Facebook)
Payers
Partners in your health care delivery ecosystem (e.g., government agencies, YMCAs or churches)
Other providers
© 2019 Advisory Board • All rights reserved • advisory.com
43
Use IT to improve the patient experience
IT will continue to play a role in building long-term consumer loyalty
Next steps and key considerations
Design a comprehensive loyalty strategy
Create a ROI for loyal consumers
Cultivate consumer champions
Establish a simplified consumer platform
• Integrated search, scheduling, and pricing
• Network of digital devices
• IT support for care navigators
• Simplified billing and payment
• Hospital navigation apps
• Rewards program software
• Premium IT for
subscription-based
services
• Customized provider search
• IT to support money-back
guarantee
• Shared decision-making
systems
• Database of consumer
information and preferences
© 2019 Advisory Board • All rights reserved • advisory.com
44
Stakeholders cannot afford to be complacent!
Digital disruption and innovation is already happening
Next steps and key considerations
Source: Health Care IT Advisor research and analysis.
Don’t overhype but don’t
underestimate
the potential for digital
disruption by thinking strictly
linearly or implicitly assuming
that the past is a reliable
predictor of the future.
Look for opportunities
for incremental and
sustaining innovation and
potential threats from
disruptive innovation.
Develop and implement a plan
to build the foundational
competencies needed to
support digital transformation
and innovation.
If sustaining innovation is
an option, then
fundamentally rethink and
digitize key customer or
internal journeys—don’t just
automate manual processes.
Develop a shared vision for the
future of health care and IT—
and digital strategy enablement
and innovation. Rethink critical
functions such as strategy, IT
governance, and funding.
Capitalize on opportunities
to collaborate w ith non-IT
leaders and IT leaders about
changes in health care, in IT
and in IT’s role in health care.
© 2019 Advisory Board • All rights reserved • advisory.com
45
Preview resources available with membership
Advisory Board members have access to national meetings featuring new research and netw orking
forums, research reports exploring industry trends and proven strategies, on-call expert
consultations, forecasting and benchmarking tools, live w ebconference presentations and an on-
demand w ebconference archive, expert-led presentations on the ground at your organization, and
expert blog posts on current health care topics.
Preview a few of the resources we’ve designed to help CIOs, IT leaders, and other C-suite
executives leverage IT as a strategic asset.
Infographic: Nine Ways to Harness the Internet of Things in Health Care
Wondering about the opportunities for the Internet of Things in health care? This
infographic identif ies data categories and representative measures you can start taking
advantage of today.
Executive Briefing: How to Get Started with Patient Generated Health Data for
Patient Monitoring
This research briefing review s essential considerations for incorporating patient-
generated health data into new or existing care programs.
Research Report: How to Address Physician Burnout through EHR Optimization
Learn w hat steps your organization can take to target EHR usability and safety issues
during EHR optimization.
Thank you. For more information on how Advisory
Board can help you and your organization please
contact us at programinquires@advisory.com
top related